Individual provider Active NPI

Lorie Rashelle Wydotis, APRN, FNP-C

  • Cardiovascular Disease Physician
  • Princeton, KY
National Provider Identifier
1457731770
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
3009572 Issued in KY
Practice address
100 Medical Center Dr
Princeton, KY 42445-2430
Phone
(270) 365-0350
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1083029 KY
Family Nurse Practitioner 363LF0000X 3009572 KY
Cardiovascular Disease Physician 207RC0000X 3009572 KY Primary

Addresses

Primary practice location

100 Medical Center Dr
Princeton, KY 42445-2430

Mailing address

100 Medical Center Dr
Princeton, KY 42445-2430
Phone (270) 365-0350

Other practice location 1

615 Old Symsonia Rd
Benton, KY 42025-1399
Phone (270) 527-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831003002 KY Practitioner - Nurse Practitioner 5294041612 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1083029KYMDRegistered Nurse
3009572KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caldwell County Hospital, Inc Cardiovascular Disease CurrentSince Jul 15, 2019 Accepting new patients
Trigg County Hospital, Inc Cardiovascular Disease CurrentSince Aug 25, 2025 Accepting new patients
Trigg County Hospital, Inc CurrentSince Aug 25, 2025 Accepting new patients
Caldwell County Hospital, Inc. CurrentSince Jul 15, 2019 Accepting new patients
Caldwell County Hospital, Inc Current Accepting new patients
Baptist Health Medical Group Inc Cardiovascular Disease Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jun 1, 2025 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jun 1, 2025 Accepting new patients
Marshall County Hospital District Past Accepting new patients

Locations

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

110 Merchant St
Cadiz, KY 42211
Phone (270) 522-3215

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

320 Micbeth Dr
Princeton, KY 42445
Phone (270) 365-0320

100 Medical Center Dr
Princeton, KY 42445
Phone (270) 365-0300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIDFCD
  • FHIR API: https://fhir-usa.unify.chbase.com/org/marshal-fc975078

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1457731770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424452430",
            "telephone_number": "270-365-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424452430",
            "telephone_number": "270-365-0350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Old Symsonia Rd",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "KY",
            "postal_code": "420251399",
            "country_code": "US",
            "telephone_number": "270-527-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYDOTIS",
        "first_name": "LORIE",
        "middle_name": "RASHELLE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1083029",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009572",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "3009572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, KY

Sources for this page

Verify at the official NPI Registry.